crossing96/oncoscreening huggingface dataset:
Radiotherapy of Primary or Recurrent Bladder Cancer in the Very Elderly.	AIM: The number of very elderly patients with cancer is growing and requires particular attention. The role of organ-sparing irradiation in patients with bladder cancer aged ≥80 years was investigated. PATIENTS AND METHODS: In 29 very elderly (≥80 years) patients irradiated for bladder cancer, 12 characteristics were analysed for survival: indication, gender, age, Karnofsky performance score (KPS), T-/N-category, tumour grade, pack years, smoking during irradiation, radiation dose, interruption of irradiation >5 days and concurrent chemotherapy. RESULTS: On univariate analysis, primary treatment (p=0.001), KPS >70 (p=0.026) and not smoking during radiotherapy (p<0.001) were associated with better survival. A strong trend for such association was observed for female gender (p=0.054), <40 pack years (p=0.064) and concurrent chemotherapy (p=0.061), and a trend for no interruption of irradiation (p=0.09). On multivariate analysis, primary treatment (p=0.006) and not smoking during radiotherapy (p=0.038) maintained significance. CONCLUSION: Very elderly patients irradiated for bladder cancer may benefit from concurrent chemotherapy. Smoking during irradiation and interruptions of irradiation should be avoided.	bladder
Effect of Hospital and Surgeon Case Volume on Perioperative Quality of Care and Short-term Outcomes After Radical Cystectomy for Muscle-invasive Bladder Cancer: Results From a European Tertiary Care Center Cohort.	BACKGROUND: Case volume has been suggested to affect surgical outcomes in different arrays of procedures. We aimed to delineate the relationship between case volume and surgical outcomes and quality of care criteria of radical cystectomy (RC) in a prospectively collected multicenter cohort. PATIENTS AND METHODS: This was a retrospective analysis of a prospectively collected European cohort of patients with bladder cancer treated with RC in 2011. We relied on 479 and 459 eligible patients with available information on hospital case volume and surgeon case volume, respectively. Hospital case volume was divided into tertiles, and surgeon volume was dichotomized according to the median annual number of surgeries performed. Binomial generalized estimating equations controlling for potential known confounders and inter-hospital clustering assessed the independent association of case volume with short-term complications and mortality, as well as the fulfillment of quality of care criteria. RESULTS: The high-volume threshold for hospitals was 45 RCs and, for high-volume surgeons, was > 15 cases annually. In adjusted analyses, high hospital volume remained an independent predictor of fewer 30-day (odds ratio, 0.34; P = .002) and 60- to 90-day (odds ratio, 0.41; P = .03) major complications but not of fulfilling quality of care criteria or mortality. No difference between surgeon volume groups was noted for complications, quality of care criteria, or mortality after adjustments. CONCLUSION: The coordination of care at high-volume hospitals might confer a similar important factor in postoperative outcomes as surgeon case volume in RC. This points to organizational elements in high-volume hospitals that enable them to react more appropriately to adverse events after surgery.	bladder
A cohort mortality study of lead-exposed workers in the USA, Finland and the UK.	OBJECTIVES: To investigate further whether inorganic lead is a carcinogen among adults, or associated with increased blood pressure and kidney damage, via a large mortality study. METHODS: We conducted internal analyses via Cox regression of mortality in three cohorts of lead-exposed workers with blood lead (BL) data (USA, Finland, UK), including over 88 000 workers and over 14 000 deaths. Our exposure metric was maximum BL. We also conducted external analyses using country-specific background rates. RESULTS: The combined cohort had a median BL of 26 µg/dL, a mean first-year BL test of 1990 and was 96% male. Fifty per cent had more than one BL test (mean 7). Significant (p<0.05) positive trends, using the log of each worker's maximum BL, were found for lung cancer, chronic obstructive pulmonary disease (COPD), stroke and heart disease, while borderline significant trends (0.05≤p≤0.10) were found for bladder cancer, brain cancer and larynx cancer. Most results were consistent across all three cohorts. In external comparisons, we found significantly elevated SMRs for those with BLs>40 µg/dL; for bladder, lung and larynx cancer; and for COPD. In a small subsample of the US cohort (n=115) who were interviewed, we found no association between smoking and BL. CONCLUSIONS: We found strong positive mortality trends, with increasing BL level, for several outcomes in internal analysis. Many of these outcomes are associated with smoking, for which we had no data. A borderline trend was found for brain cancer, not associated with smoking.	bladder
Impact of body mass index on robot-assisted radical cystectomy with intracorporeal urinary diversion.	OBJECTIVES: To determine the impact of body mass index (BMI) on peri-operative and oncological outcomes after robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion. PATIENTS AND METHODS: A total of 216 patients undergoing RARC, extended lymphadenectomy and intracorporeal urinary diversion, between July 2010 and December 2015, were categorized into four BMI groups according to the 2004 World Health Organization obesity classification groups: <25 kg/m(2) (normal); 25-29.9 kg/m(2) (pre-obese); 30-34.9 kg/m(2) (obese class I); and ≥35 kg/m(2) (obese class II). Pre-, intra- and postoperative characteristics, oncological outcomes, and 90-day complications were compared using sas statistical software. RESULTS: All 216 patients underwent intracorporeal urinary diversion, with 68 (32%) undergoing orthotopic neobladder construction. Demographics were similar among the BMI groups with regard to median (range) age (71.8 [35- 95] years), gender (80.6% men), Charlson comorbidity index (CCI) score (66.2% with CCI score 0-1), pathological stage (carcinoma in situ to T2: 55.1%, T3-T4/N0: 18.5%, Tx/N+: 26.4%), median (interquartile range) node count [41 (28, 53)] and positive soft tissue margin rate (4.2%). Obese patients had greater blood loss and longer operating time (P = 0.02 and P = 0.04, respectively). There were no significant differences in length of hospital stay, transfusion rates, readmission or 90-day overall and high-grade complication rates (P = 0.16, P = 0.96, P = 0.89, P = 0.22 and P = 0.51, respectively). At a median (range) follow-up of 13 months (15 days to 4.8 years), recurrence-free survival (P = 0.92) and overall survival (P = 0.68) were similar among the groups. CONCLUSION: The results of the present study show that RARC with intracorporeal urinary diversion is safe and feasible in obese patients with bladder cancer. BMI was not associated with significant differences in peri-operative, pathological or early oncological outcomes.	bladder
Factors affecting the timeliness and adequacy of haematuria assessment in bladder cancer: a systematic review.	OBJECTIVES: To review the literature to identify factors affecting haematuria assessment in bladder cancer. METHODS: We performed a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Publications indexed in EMBASE and Medline (PubMed) in March 2016 were searched, using the keywords 'hematuria', 'urinary bladder neoplasm(s)' and 'bladder tumor'. Studies evaluating the timeliness and adequacy of haematuria assessment in the context of bladder cancer were included. Exclusion criteria included age <18 years, animal studies and non-English articles. RESULTS: Following our search strategy, a total of 17 articles were included in our study. All 17 studies commented on gender, with female gender associated with delayed and inadequate haematuria evaluation. Women waited longer than men for urological review (three studies) and bladder cancer diagnosis (three studies). Women were also less likely to be referred to urology (two studies), receive imaging (three studies) or have cystoscopy (two studies). In all, 10 studies commented on age, with the impression that advancing age is associated with a more thorough assessment. Smokers and those with microscopic haematuria appear to undergo a less thorough evaluation. CONCLUSION: Female gender is associated with sub-optimal haematuria evaluation, while older patients are evaluated more thoroughly. Smokers paradoxically undergo less comprehensive assessment. Further research on the impact of other factors is required.	bladder
Photodynamic Diagnosis and Narrow-Band Imaging in the Management of Bladder Cancer: A Review.	BACKGROUND: Bladder cancer is the most common malignancy of the urinary tract. Its proper diagnosis and efficient treatment is still considered a challenge in urology today. White light cystoscopy is a gold standard for the diagnosis, follow-up, and endoscopic treatment of bladder cancer. To improve the efficacy of bladder cancer management, photodynamic diagnosis and narrow-band imaging have been introduced to the urological armamentarium. OBJECTIVE AND METHODS: The article presents the current state of knowledge of technical solutions that are intended to improve the diagnosis and management of bladder cancer. A nonsystemic review of relevant PubMed literature was performed. RESULTS: Photodynamic diagnosis and narrow-band imaging improve the detection of bladder cancer and decrease recurrence rates of bladder tumors. CONCLUSIONS: Although the high cost of the equipment may limit its introduction to everyday use, it is a cost-effective method of bladder cancer management for long-term follow-up.	bladder
Prediction of Multiple Recurrent Events: A Comparison of Extended Cox Models in Bladder Cancer.	Recurrence of bladder cancer can occur repeatedly in the same patient after treatment of the primary tumor. Models predicting the risk of a next recurrence may inform individualized decision-making on surveillance frequency. We aimed to assess the usefulness of extensions of the Cox proportional hazards model for repeated events in this context. We analyzed 531 Dutch patients with bladder cancer (1990-2012) with information on 7 prespecified predictors at the time of diagnosis of the primary and recurrent tumors. We considered 3 aspects of model variants: how to model time to the repeated events (calendar time, gap time, elapsed time); the number of preceding events (predictor, stratum variable); and the within-subject correlation (ignored in a simple Cox model, robust standard errors in a variance-correction model, random effect in a frailty model). First to fourth recurrences of bladder cancer occurred in 313, 174, 103, and 66 patients, respectively, with median calendar follow-up times of 1.1, 2.5, 3.8, and 4.5 years, respectively. We focused on gap time in the detailed analyses, allowing for clinically meaningful predictions. Variance-correction models may be useful if predictor selection is part of the model development. Frailty models may be useful when within-subject correlation is strong.	bladder
CIP2A mediates fibronectin-induced bladder cancer cell proliferation by stabilizing β-catenin.	BACKGROUND: Fibronectin (FN) is associated with tumorigenesis and progression in bladder cancer, however, the underlying mechanisms causing this remain largely unknown. Furthermore, cancerous inhibitor of protein phosphatase 2A (CIP2A) has been shown to play important regulatory roles in cancer proliferation. Here, we investigated whether FN regulates CIP2A expression to promote bladder cancer cell proliferation. METHODS: The correlations of stromal FN with CIP2A and proliferating cell nuclear antigen (PCNA) expression were analyzed in a cohort bladder cancer patients. The roles of FN and CIP2A in regulating bladder cancer cell proliferation were evaluated in cell and animal models. Cycloheximide treatment was used to determine the effects of CIP2A on β-catenin stabilization. The CIP2A-β-catenin interaction was confirmed by immunofluorescence staining and co-immunoprcipitation. RESULTS: In this study, we found that stromal FN expression correlated positively with the levels of CIP2A and PCNA in bladder cancer tissues. Meanwhile, in human bladder cancer cell lines (T24 and J82), exogenous FN significantly promoted cell proliferation, however, CIP2A depletion inhibited this process. Furthermore, the interaction between CIP2A and β-catenin enhanced the stabilization of β-catenin, which was involved in FN-induced cell proliferation. In vivo, CIP2A depletion repressed FN-accelerated subcutaneous xenograft growth rates. CONCLUSIONS: These data reveal that CIP2A is a crucial mediator of FN-induced bladder cancer cell proliferation via enhancing the stabilization of β-catenin. Promisingly, FN and CIP2A could serve as potential therapeutic targets for bladder cancer treatment.	bladder
Standardization of the apparent diffusion coefficient value of bladder cancer across different centers: Applicability in predicting aggressive pathologic phenotypes.	PURPOSE: We investigated whether the standardized apparent diffusion coefficient (ADC) value reflects bladder cancer characteristics across different centers. METHODS: Ninety-eight bladder cancer patients underwent MRI at two institutions. Standardized tumor ADC (sT-ADC) was calculated by dividing absolute tumor ADC (aT-ADC) by that of gluteus maximus. We compared ADCs between MRI protocols according to grade and T-stage. RESULTS: The differences in aT-ADC between MRI protocols were negated by sT-ADC. The best sT-ADC cut-offs to predict cancer aggressiveness in the development cohort worked in the validation cohort compared to the development cohort. CONCLUSION: Standardized ADC overcomes the incompatibility between different MRI protocols.	bladder
Fibulin-3 promotes muscle-invasive bladder cancer.	Urothelial carcinoma is the most common type of bladder cancer and can be categorized as either non-muscle-invasive (Ta-T1) or muscle-invasive (⩾T2). The majority of bladder cancers are non-muscle-invasive at presentation; however, the recurrence rate for these tumors is high and a subset can progress to T2. In this study, we aimed to identify genes differentially expressed between T1 vs T2 bladder cancer to identify key regulators of bladder cancer progression and/or invasion. We performed RNA-Seq on T1 and T2 bladder cancer tissues and used publicly available bladder cancer profiling studies to prioritize differentially expressed genes for validation and functional assessment. This integrative approach nominated an extracellular matrix glycoprotein, fibulin-3 (FBLN3, also known as EFEMP1), as being highly expressed in T2 vs T1 bladder cancer and aggressive vs indolent disease. We confirmed the overexpression of fibulin-3 in ⩾T2 vs non-muscle-invasive bladder cancer (NMIBC) by quantitative reverse transcriptase-PCR. Consistent with these findings, fibulin-3 expression level correlated with the invasive ability of several bladder cancer cell lines and modulation of fibulin-3 expression directly affected invasion. Fibulin-3 knockdown in bladder cancer cells decreased the incidence of MIBCs in a murine orthotopic bladder cancer model and decreased the expression of insulin-like growth factor-binding protein-5 (IGFBP5). Restoring IGFBP5 in these cells rescued their invasive and migratory potential. These results indicate that fibulin-3 serves as a pro-invasive factor in bladder cancer, which may be mediated through modulation of IGFBP5 expression. This also suggests fibulin-3 and IGFBP5 may have potential as biomarkers of aggressive bladder cancer or therapeutic targets.	bladder
A novel fusion of HNRNPA1-ALK in inflammatory myofibroblastic tumor of urinary bladder.	Here, we report an inflammatory myofibroblastic tumor (IMT) of the urinary bladder with a novel HNRNPA1-ALK fusion. To the best of our knowledge, this is the first case of a tumor with HNRNPA1-ALK fusion. A 42-year-old Japanese man underwent total cystectomy because of an invasive urinary bladder tumor. Grossly, the tumor had invaded the peribladder fat tissue. Histologically, it comprised spindle neoplastic cells with intermingled inflammatory cells. Immunohistochemically, it was positive for ALK, SMA, desmin, cytokeratin, and vimentin, consistent with the immunohistochemical characteristics of IMTs. Fluorescence in situ hybridization demonstrated an ALK split, and the presence of HNRNPA1-ALK was revealed by RNA sequencing. We identified a novel transcript fusion of exon 2 of HNRNPA1 and exon 18 of ALK, resulting in ALK protein overexpression. These findings provide useful information on the biology and tumorigenesis of IMTs, thus facilitating the development of molecular-targeted therapeutics.	bladder
A Rare Case of Intravesical Angiomyofibroblastoma.	OBJECTIVE: To study the first reported case of intravesical angiomyofibroblastoma (AMFB). AMFB is an uncommon benign mesenchymal lesion, mostly described in the lower female genital tract, especially in the vulva and less commonly in the vagina. It is rarely seen in the male genital tract. The importance of this rare neoplasm is related to its potential mimicry of more infiltrative and prognostically less favorable lesions, such as aggressive angiomyxomas, that are found in the same anatomic area. METHODS: A 26-year-old man presented to us with hematuria. Investigations revealed an intraluminal polypoidal lesion of approximately 92 × 77 × 76 mm within the urinary bladder. Cystoscopy revealed a large well-circumscribed tumor with a pedicle, attached to the inferolateral wall of the bladder near the bladder neck. Open exploration and en bloc excision of the bladder mass was done. RESULTS: Histopathology and immunohistochemistry (IHC) confirmed the diagnosis of AMFB. CONCLUSION: AMFB presents as a well-circumscribed superficial mass. Complete excision of the tumor for histopathologic and IHC examination is essential for diagnosis. This rare tumor shows morphologic similarity to some more aggressive tumors with less favorable outcome; hence, it needs to be differentiated from those. IHC is helpful but not always conclusive in the diagnosis of this rare neoplasm. This being the first-ever reported case of intravesical AMFB bears a significant importance. Careful clinical assessment, operative management, and histopathologic examination are of utmost importance in making a precise diagnosis and management of the patient.	bladder
Urothelial papilloma: a rare cause of gross haematuria in childhood.	Bladder urothelial papilloma is extremely rare in the paediatric population. It usually presents as painless gross haematuria and its diagnosis implies a high index of suspicion as other causes of haematuria predominate in this age range. We describe a 9-year-old boy with two episodes of gross haematuria occurring 1 year apart with spontaneous resolution after 2 days. Bladder ultrasound revealed an endovesical papillary lesion of 24×24 mm suggestive of bladder tumour. The diagnosis was confirmed by histopathological examination of the specimen obtained by cystoscopy with transurethral resection. After 3 years of follow-up with ultrasound and cystoscopy, there are no signs of recurrence. Due to the low prevalence of urothelial papilloma, paediatric guidelines for appropriate management and follow-up are unavailable, making this a challenging entity.	bladder
The expression of keratin 6 is regulated by the activation of the ERK1/2 pathway in arsenite transformed human urothelial cells.	Urothelial cancers have an environmental etiological component, and previous studies from our laboratory have shown that arsenite (As(+3)) can cause the malignant transformation of the immortalized urothelial cells (UROtsa), leading to the expression of keratin 6 (KRT6). The expression of KRT6 in the parent UROtsa cells can be induced by the addition of epidermal growth factor (EGF). Tumors formed by these transformed cells have focal areas of squamous differentiation that express KRT6. The goal of this study was to investigate the mechanism involved in the upregulation of KRT6 in urothelial cancers and to validate that the As(+3)-transformed UROtsa cells are a model of urothelial cancer. The results obtained showed that the parent and the As(+3)-transformed UROtsa cells express EGFR which is phosphorylated with the addition of epidermal growth factor (EGF) resulting in an increased expression of KRT6. Inhibition of the extracellular-signal regulated kinases (ERK1/2) pathway by the addition of the mitogen-activated protein kinase kinase 1 (MEK1) and MEK2 kinase inhibitor U0126 resulted in a decrease in the phosphorylation of ERK1/2 and a reduced expression of KRT6. Immuno-histochemical analysis of the tumors generated by the As(+3)-transformed isolates expressed EGFR and tumors formed by two of the transformed isolates expressed the phosphorylated form of EGFR. These results show that the expression of KRT6 is regulated at least in part by the ERK1/2 pathway and that the As(+3)-transformed human urothelial cells have the potential to serve as a valid model to study urothelial carcinomas.	bladder
Virtual cystoscopy, computed tomography urography and optical cystoscopy for the detection and follow-up for bladder cancer.	OBJECTIVES: To evaluate the utility of virtual cystoscopy (VC) performed with CT urography in patients being studied under gross hematuria or patients being followed-up after a previous bladder cancer and compare the results with those obtained with gold standard technique (optical cystoscopy). METHODS: Retrospective study of 117 patients who were referred for VC by the Urology Department between May 2014 and May 2015. Those patients presented with gross hematuria or they were previously treated patients from bladder cancer being followed up. These patients were evaluated with MDCT and virtual cystoscopy after distending the bladder with air. The results were compared with those obtained with optical cystoscopy which was performed no more than a week after. RESULTS: The global sensitivity and specificity of VC were 81,8 and 92,1%. Aditional findings detected in CT urography were an aortic dissection, urinary lithiasis and colonic metastasis. CONCLUSION: VC seems an useful technique in the diagnosis and follow-up for bladder cancer with a good correlation with OC. The main limitations are the impossibility of biopsy during the procedure and the detection of erythematous lesions. Collateral findings can be detected performed with CT urography although the high radiation exposure does not recommend their combined use.	bladder
Miconazole induces apoptosis via the death receptor 5-dependent and mitochondrial-mediated pathways in human bladder cancer cells.	Miconazole (MIC), an antifungal agent, diplays anti‑tumorigenic activity in various types of human cancers, including bladder cancer, yet its mechanism of antitumor action is not well understood. In the present study, we demonstrated that, in a cell viability assay, MIC had a cytotoxic effect on human T24, J82 and TSGH-8301 bladder cancer cells in a dose- and time‑dependent manner, but did not exhibit significant toxicity toward human peripheral blood mononuclear cells. Cell cycle analysis revealed that MIC at concentrations of 25 and 50 µM significantly caused G0/G1 arrest in the TSGH-8301 and T24 cells, respectively. DNA fragmentation, mitochondrial membrane potential and western blot analyses showed that MIC inhibited the growth of these cells by both mitochondrial‑mediated and death receptor (DR5)‑mediated apoptosis pathways. Specifically, MIC increased the protein levels of p21 and p27, but decreased the expression of cyclin E1, CDK2 and CDK4. MIC augmented the expression of DR5, cleaved forms of caspase-3 -8 and -9, poly(ADP‑ribose) polymerase and Bax, decreased the expression of Bcl-2 but increased cytosol levels of cytochrome c. Our results suggest that MIC inhibits the growth of bladder cancer cells through induction of G0/G1 arrest and apoptosis via activation of both the extrinsic and intrinsic apoptotic pathways. MIC is a potential chemotherapeutic agent for treating bladder cancer in humans.	bladder